Empyema of the thorax in adults: review of 105 cases.

Thoracic empyema has become an uncommon disease in adults, tending to occur in chronically ill debilitated individuals. In this series, pulmonary infection was the underlying cause in more than half the cases, with bronchogenic carcinoma or other serious lung disease present in one fifth of the pulmonary infections. Thoracic surgery preceded almost one quarter of all cases. Staphylococcus aureus and gram-negative bacilli were the most commonly found organisms. Successful therapy is founded on correct choice and adequate dose of antibiotics, prompt institution of adequate drainage, and recognition and treatment of underlying factors. Decortication, with or without pulmonary resection, and thoracoplasty continue to have a place in treating chronic empyema. Empyema contributed to death in less than five percent of this series. However, overall mortality was just under 50 percent reflecting the occurrence of pleural sepsis in patients with a variety of serious neoplastic and degenerative diseases.